Posted by Alan on October 13, 2002, at 10:29:19
In reply to Re: Day 6 on 10 mg » Micki, posted by pharmrep on October 13, 2002, at 2:09:35
YMMV but - A close relative told me about his experience with switching over to Lex. from Celexa for an anxiety disorder and it esentially went something like this:
....Been on Celexa since it came onto the market and it has helped me better than anything else I have ever taken (the list is to long to even think about). PDoc recently asked me to consider switching to Lexapro, which is similar to Celexa without the isomer that causes most of the side effects. However, the Lexapro made me extremely anxious so possibly the sleepiness side effect of Celexa was what I needed. I went back on the Celexa feel better but back to the usual sedation problem....
In response, I didn't want to say anything about the whimsical idea that all of the side effects would reside in the (removed) mirror image molecule and all the therapeutic effect would reside in the remaining molecule, but it's not surprising he discovered that on his own.
Doctors will fall for some pretty flimsy lines if delivered with a straight face and a pert attitude. Any biologist could tell them that when mirror-image isomers of molecules exist, it tends to be so that most of the biological activity resides in one isomer and the other is nearly inactive. However, the isolated-isomer version of Prozac never made it to market because it turned out to be dangerous, so the "one isomer active" rule may apply more to naturally occurring substances than it does to synthetic drugs.
Judging from the public statements I've heard, few authorities who are financially independent of Forest Pharmaceuticals expect Lexapro to be systematically better than Celexa for anything except the maker's bottom line. (There could be a few individual exceptions.) Same goes for Nexium compared to Prilosec and all these other analogous "next-generation" pills.
Interesting how the next generation always makes it to market just as the previous one's patent is expiring.
Skeptical in Seattle,
Alan
poster:Alan
thread:109458
URL: http://www.dr-bob.org/babble/20021012/msgs/123451.html